National Provider Identifier Database

OUTPATIENT RADIOLOGY CLINIC PA
Diagnostic Radiology

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.


Contact Information

OUTPATIENT RADIOLOGY CLINIC PA
200 SOUTH ROHDES
STE B
WEST MEMPHIS, AR72301
Phone: 870-735-5555
Fax: 870-735-5660
Website:
Specialty Taxonomy Code
* Diagnostic Radiology 2085R0202X

* Indicates primary specialty

NPI Profile & details for OUTPATIENT RADIOLOGY CLINIC PA

NPI Number 1265651459
Legal business name
LBN
OUTPATIENT RADIOLOGY CLINIC PA
Authorized official EDGAR FERGUSON - (PHYSICIAN RADIOLOGIST)
Entity Organization
Organization subpart No
Enumeration date 04/25/2007
Last updated 08/22/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • AR License #: C6304
  • TN License #: MD14662

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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